Evidence map›Paper›PMID 40747746›Full record

Trial reportEuropean journal of clinical investigation2026

Circulating hsa-miR-29c-3p and VEGF-A levels predict the response to FOLFIRI plus aflibercept in elderly metastatic colorectal cancer patients.

Marta Toledano-Fonseca, María Teresa Cano-Osuna, Elena Élez, Javier Soto-Alsar, David Páez, Ana Fernández-Montes, Begoña Graña, Antonieta Salud, Alfonso Yubero, Ismael Macías and 9 more

Abstract readClinical Trial, Phase II
In one paragraph

Trial report in European journal of clinical investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Marta Toledano-FonsecaMaimonides Biomedical Research Institute of Córdoba (IMIBIC), Medical Oncology Department, Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain.ORCID https://orcid.org/0000-0002-1997-9197
María Teresa Cano-OsunaMaimonides Biomedical Research Institute of Córdoba (IMIBIC), Medical Oncology Department, Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain.
Elena ÉlezMedical Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Vall d'Hebron Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, CIBERONC, Barcelona, Spain.
Javier Soto-AlsarMedical Oncology Department, Gregorio Marañón General University Hospital, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense, Madrid, Spain.
David PáezMedical Oncology Department, Hospital de la Santa Creu i Sant Pau, CIBERER, Barcelona, Spain.
Ana Fernández-MontesMedical Oncology Department, Complejo Hospitalario Universitario de Ourense, Ourense, Spain.
Begoña GrañaMedical Oncology Department, Pontevedra University Hospital (SERGAS), Galicia Sur Health Research Institute (IISGS), Pontevedra, Spain.
Antonieta SaludMedical Oncology Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain.
Alfonso YuberoMedical Oncology Department, University Hospital Lozano Blesa, Institute for Health Research Aragon (IIS Aragón), Zaragoza, Spain.
Ismael MacíasMedica Oncology Department, Hospital Parc Taulí de Sabadell, Barcelona, Spain.
Guillermo QuinteroMedical Oncology Department, Hospital Lucus Augusti, Lugo, Spain.
Carlos López-LópezMedical Oncology Department, Hospital Universitario Marqués de Valdecilla, IDIVAL, UNICAN, Santander, Spain.
Teresa Fernández-RodríguezMedical Oncology Department, Hospital Universitario Son Llatzer, Mallorca, Spain.
María Victoria García-OrtizMaimonides Biomedical Research Institute of Córdoba (IMIBIC), Medical Oncology Department, Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain.
Javier SastreMedical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Hospital Clínico San Carlos (IdISSC), Universidad Complutense, Madrid, Spain.
Pilar García-AlfonsoMedical Oncology Department, Gregorio Marañón General University Hospital, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense, Madrid, Spain.
Antonio Rodríguez-ArizaMaimonides Biomedical Research Institute of Córdoba (IMIBIC), Medical Oncology Department, Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain.
Enrique ArandaMaimonides Biomedical Research Institute of Córdoba (IMIBIC), Medical Oncology Department, Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain.
Spanish Cooperative Group for the Treatment of Digestive Tumours (TTD)

Funding

Sanofi EspañaSpanish Cooperative Group for the Treatment of Digestive Tumours (TTD) y7aXUW6W
6 · The paper itself

Abstract

backgroundMetastatic colorectal cancer (mCRC) patients who progress on oxaliplatin-based chemotherapy benefit from second-line treatment with FOLFIRI plus the antiangiogenic drug aflibercept. However, the absence of validated biomarkers for antiangiogenic therapies remains a challenge. In this context, we previously reported that combining plasma VEGF-A levels, a circulating microRNA profile, and patient clinical characteristics predicts outcomes in FOLFIRI plus aflibercept treatment. In the present study, we now report biomarkers of response to FOLFIRI plus aflibercept in elderly mCRC patients who progressed after first-line oxaliplatin-based chemotherapy.

methodsThe study included 154 mCRC patients over 70 years of age enrolled in the clinical phase II trial AFEMA. Plasma samples were obtained before FOLFIRI plus aflibercept treatment, and circulating levels of VEGF-A and 13 miRNAs were analysed.

resultsThe levels of VEGF-A and five of these 13 miRNAs (miR-193-3b, miR-432-5p, miR-29c-3p, miR-93-5p, miR-30a-3p) enabled the stratification of patients based on progression-free survival and time-to-treatment failure. Specifically, combining miR-29c-3p with VEGF-A improved prognostic accuracy.

conclusionOur study underscores the value of integrating miR-29c-3p analysis with VEGF-A as a biomarker strategy to advance the management of elderly mCRC patients receiving FOLFIRI plus aflibercept, improving outcome predictions and enabling more personalised therapeutic strategies.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsColorectal NeoplasmsMicroRNAsRecombinant Fusion ProteinsVascular Endothelial Growth Factor AAgedAged, 80 and overAngiogenesis InhibitorsBiomarkers, TumorCamptothecinFemaleFluorouracilHumansLeucovorinMaleProgression-Free SurvivalafliberceptAngiogenesis InhibitorsBiomarkers, TumorCamptothecinFluorouracilLeucovorinMicroRNAsMIRN29a microRNA, humanReceptors, Vascular Endothelial Growth FactorRecombinant Fusion ProteinsVascular Endothelial Growth Factor AVEGFA protein, humanafliberceptantiangiogenic therapycirculating miRNAsFOLFIRImetastatic colorectal cancerVEGF‐A

Identifiers

PMID40747746
PMCPMC12811837

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.